[alistairSH]

After that, all excess charges are handled by the insurance company until the insurance year resets.

This is an important point. And a related point.

- Because the OOP payments reset annually, there are perverse incentives to over consume medical care after OOP is reached within a given year. Defer preventative health care until after you have a major medical problem that runs to max OOP, then stack up on preventative care before the year ends.

- Related: Insurance is also tied to employer - if you change jobs, all those OOP values reset (to whatever policies are in place with new employer). This causes friction in the labor market - employer-provided and -subsidized health care prevents people from looking for new employment.